Christina A. Metzler, Kimberly D. Hartmann, Lisa A. Lowenthal; Defining Primary Care: Envisioning the Roles of Occupational Therapy. Am J Occup Ther 2012;66(3):266-270. doi: 10.5014/ajot.2010.663001.
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the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (§ 3502)
The Obama Administration believes that strengthening and growing our primary care workforce is critical to reforming the nation’s health care system. Increasing access to primary care physicians and nurses can help prevent disease and illness and ensure all Americans—regardless of where they live—have access to high quality care. It can also reduce costs by increasing access to preventive care. (healthreform.gov, n.d., para. 2)
Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an “integrator”) that accepts responsibility for all three aims for that population. The integrator’s role includes at least five components: partnership with individuals and families, redesign of primary care, population health management, financial management, and macro system integration. (Berwick, Nolan, & Whittington, 2008, p. 759)
We believe that any effective integrator will strengthen primary care for the population. To accomplish this, physicians might not be the sole, or even the principal, providers. Recently, physicians and other clinicians have proposed principles for expanding the role of primary care under the title of the “medical home.” This expanded role includes establishing long-term relations between patients and their primary care team; developing shared plans of care; coordinating care, including subspecialists and hospitals; and providing innovative access to services through improved scheduling, connection to community resources, and new means of communication among individuals, families, and the primary care team facilitated by a patient-controlled personalized health record. (p. 759)
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